Business for (130) and not for profit (16)

SNAP-Ed Toolkit Submission Form and Scoring Tool (FNS 885 and FNS 886) w/ Screenshots

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0639 can be found here:

Documents and Forms

Document Name Document Type
Form FNS 885 Business for (130) and not for profit (16) Form and Instruction
FNS 885 SNAP-ED TOOLKIT INTERVENTION SCORING TOOL Appendix 1 - FNS 885 Qualtrics Version.docx snapedtoolkit.org/interventions/submit-an-intervention. Form and Instruction
FNS 885 SNAP-ED TOOLKIT INTERVENTION SCORING TOOL Appendix 1 - FNS 885 Qualtrics Version.docx snapedtoolkit.org/interventions/submit-an-intervention. Form and Instruction
FNS 886 SNAP-ED TOOLKIT INTERVENTION SUBMISSION FORM Appendix 2 - FNS 886 Qualtrics Version .docx snapedtoolkit.org/interventions/submit-an-intervention. Form and Instruction
FNS 886 SNAP-ED TOOLKIT INTERVENTION SUBMISSION FORM Appendix 2 - FNS 886 Qualtrics Version .docx snapedtoolkit.org/interventions/submit-an-intervention. Form and Instruction
FNS 885 SNAP-ED TOOLKIT INTERVENTION SCORING TOOL Appendix 3 - FNS 885 - AEM 6-29-21.pdf Form and Instruction
FNS 885 SNAP-ED TOOLKIT INTERVENTION SCORING TOOL Appendix 3 - FNS 885 - AEM 6-29-21.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Business for (130) and not for profit (16)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR § 272.2(2)(d) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FNS 885	SNAP-ED TOOLKIT INTERVENTION SCORING TOOL	Appendix 1 - FNS 885 Qualtrics Version.docx	https://snapedtoolkit.org/interventions/submit-an-intervention.	Yes	No	Fillable Printable
Form and Instruction	FNS 886	SNAP-ED TOOLKIT INTERVENTION SUBMISSION FORM	Appendix 2 - FNS 886 Qualtrics Version .docx	https://snapedtoolkit.org/interventions/submit-an-intervention.	Yes	Yes	Fillable Fileable Signable
Form and Instruction	FNS 885	SNAP-ED TOOLKIT INTERVENTION SCORING TOOL	Appendix 3 - FNS 885 - AEM 6-29-21.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS-8 USDA/FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 146	Number of Respondents for Small Entity: 4

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	178	21	102	55
Annual IC Time Burden (Hours)	414	183	0	231
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.